Provider Demographics
NPI:1932263332
Name:RURAL HEALTH, INC.
Entity Type:Organization
Organization Name:RURAL HEALTH, INC.
Other - Org Name:VIENNA MEDICAL CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:K
Authorized Official - Last Name:FLAMM
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:618-833-4471
Mailing Address - Street 1:513 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ANNA
Mailing Address - State:IL
Mailing Address - Zip Code:62906-1668
Mailing Address - Country:US
Mailing Address - Phone:618-833-4471
Mailing Address - Fax:618-833-8878
Practice Address - Street 1:803 N 1ST ST
Practice Address - Street 2:
Practice Address - City:VIENNA
Practice Address - State:IL
Practice Address - Zip Code:62995
Practice Address - Country:US
Practice Address - Phone:618-658-2811
Practice Address - Fax:618-658-2439
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RURAL HEALTH, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-12-20
Last Update Date:2018-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL9115004OtherBLUE CROSS BLUE SHIELD
IL055761OtherHEALTH ALLIANCE
IL111760OtherHEALTHLINK
IL111760OtherHEALTHLINK
IL=========003Medicaid
IL141818Medicare Oscar/Certification